Lasik providers in Boston area? - Page 2

#39 03-02-2004, 03:07 PM

On 2 Mar 2004 15:00:32 GMT, "Wayne S. Hill" <hillw4[at]asme.org> wrote:

- quote -

> Dr. Leukoma wrote:
> > Also, with your low prescription, don't ignore the
> > possibility of surface ablation, either "advanced" or PRK.
> > > DrG
> Thanks. I have to admit that I'm not up on the pros and cons of
> the various techniques. I'm working on it.

Do look into it. There are a number of options.

The MAIN pro's/con's of surface ablation are: no flap/discomfort &
healing from scraping the epithelial layer off...

There are other pro's/con's, but those are probably the ones you'll
see discussed most.

DO YOUR RESEARCH, FOLLOW YOUR INSTINCTS.

Rick

#38 03-02-2004, 03:00 PM

Dr. Leukoma wrote:

- quote -

> Also, with your low prescription, don't ignore the
> possibility of surface ablation, either "advanced" or PRK.
> DrG

Thanks. I have to admit that I'm not up on the pros and cons of
the various techniques. I'm working on it.

--
-Wayne

#37 03-02-2004, 02:57 PM

Dr. Leukoma wrote:

- quote -

> With such little astigmatism, why haven't you tried soft
> contact lenses? In soft lenses I have run in the Texas
> summers, whitewater rafted, mountain biked, etc., and have
> never had an issue with any sport, including swimming.
> Haven't tried kayaking. I just fit a guy who does extreme
> biking with bifocal soft lenses because he needed to be able
> to read his maps and his wristwatch as well as be able to
> see obstacles in his path.
> Good luck in your decision.

I did give that some thought. I used to wear gas-permeable hard
contacts (not the same as soft, obviously), and got sick of them.
I had a lot of trouble with sweat and lotions getting in my eyes
in hot weather (and had similar problems with chemicals in my
work). I didn't like having to fuss with them, either, but it was
problems with spring allergies that ultimately drove me away from
them.

--
-Wayne

#36 03-02-2004, 01:01 PM

Also, with your low prescription, don't ignore the possibility of surface
ablation, either "advanced" or PRK.

DrG

"Wayne S. Hill" <hillw4[at]asme.org> wrote in
news:Xns949FD1E806F1E8ch[at]127.0.0.1:

- quote -

> Glenn - USAeyes.org wrote:
> > There is a doctor in the Boston area who is going through
> > our certification process, but is not fully certified at
> > this time. If you want his contact information to check him
> > out, email me directly.
> I saw that. I will send you e-mail.
> Perhaps you can comment on something that's stated in my
> referred doc's literature: "He was a principal investigator in
> 2 major studies on radial and astigmatic keratotomy, and a co-
> investigator in FDA-sanctioned trials resulting in approval of
> the excimer laser for hyperopia."
> I checked in Entrez Pub-Med, but didn't find those particular
> papers (although they may not have been published in journals
> covered by Pub-Med). I did find a bunch of papers (27) in which
> he's listed as an author, including 12 in which he's listed as
> primary author. The most recent paper was in 1995.
> I take this stuff as a good sign, but obviously the specific
> questions regarding practice and outcomes are the most relevant.
> > For this doctor and any others, I recommend you use our 50
> > Tough Questions For Your Doctor to evaluate a prospective
> > surgeon.
> Got it, thanks. What do you think of LECB's quoted price range
> of $2250-2900 per eye?

#35 03-02-2004, 12:56 PM

RT <RTMD24[at]yahoo.com> wrote in message news:<vLT0c.32366$OU5.15301[at]newssvr25.news.prodigy.com> ...
- quote -

> In article <itu7409jb6ho7jgeqp4agcopertcrkhlgj[at]4ax.com> ,
> SickRick <SR[at]com.com> wrote:
> > Fact of the matter is; chances are we'll ALL need reading glasses as
> > we get older and presbyopia sets in. Something I considered alot -
> > why dump glasses, only to have to wear them again soon?
> This poster needs to weigh the pros and cons for himself with his
> lifestyle choices. It seems like glasses are a real hinderance to his
> outdoor activities. But it's not a given that he'll need reading
> glasses. In fact, I think he mentioned that he already removes his
> glasses for reading.

If he is myopic, and removes his glasses for reading, that would
indicate that he is presbyopic. It is well understood and no secret
that eliminating myopia in presbyopes frequently (depending how much
accommodation they have left) means they will have to wear reading
glasses, because it was the myopia itself that permitted them to read
without glasses (ie in lieu of lost accommodation). Just last night I
was just reading some comments about this in the Patient Selection
section of "LASIK for Technicians" by Al Lens from which I quote:
"These people [myopes who are presbyopic] need to understand the
consequences of eliminating the myopia that is currently allowing them
to read. A fair number of people do not fully understand presbyopia;
they feel that they should still be able to read without glasses after
surgery since they are able to do so preoperatively. Some of these
people would prefer to use glasses for seeing in the distances rather
than wearing them while at work. Granted, most people prefer good
distance vision and rely on reading glasses, if necessary...."

As you said, RT, it's a lifestyle choice for sure. The important thing
is that patients understand and assess the tradeoff in the context of
their occupation and leisure activities, because doctors sometimes
assume patients understand more about presbyopia than most of us
actually do.

For many people, it is worth giving up some near vision for the sake
of having glasses-free distance vision. For many others it is not. It
depends on which activities are most important to them and how much
corrective lenses may be interfering with some of those activities.

#34 03-02-2004, 12:54 PM

"Wayne S. Hill" <hillw4[at]asme.org> wrote in
news:Xns949F6C7F7C45B8ch[at]127.0.0.1:

- quote -

> I googled this group, and found only a couple of relevant posts
> warning against cut-rate surgeons in my area. I've also visited
> the various websites suggested here and found good information.
> I'm 47 years old, have fairly mild myopia (-2.5 and -2.75) and
> mild astigmatism (-.5 both eyes), and currently have 20/15 or
> better vision with glasses. I'm considering Lasik because
> glasses greatly hinder my outdoor activities of highland games
> (an all-weather sport) and kayaking. I'm willing to live with
> reading glasses (add 1.25 both eyes) if I can ditch glasses for
> distance vision. I've worn hard contact lenses in the past, but
> found them to be too much of a hassle and not secure enough to
> use in kayaking in rough conditions.

With such little astigmatism, why haven't you tried soft contact lenses?
In soft lenses I have run in the Texas summers, whitewater rafted, mountain
biked, etc., and have never had an issue with any sport, including
swimming. Haven't tried kayaking. I just fit a guy who does extreme
biking with bifocal soft lenses because he needed to be able to read his
maps and his wristwatch as well as be able to see obstacles in his path.

Good luck in your decision.

DrG

#33 03-02-2004, 06:00 AM

On Tue, 02 Mar 2004 04:06:51 GMT, RT <RTMD24[at]yahoo.com> wrote:

- quote -

> In article <itu7409jb6ho7jgeqp4agcopertcrkhlgj[at]4ax.com> ,
> SickRick <SR[at]com.com> wrote:
> > Fact of the matter is; chances are we'll ALL need reading glasses as
> > we get older and presbyopia sets in. Something I considered alot -
> > why dump glasses, only to have to wear them again soon?
> Rick, this is not true. As much as it may pain me to agree with FM, low
> myopes do not necessarily need reading glasses as they get older. In
> fact, my mother removes her glasses to read. She tried a single contact
> for monovision and found it disturbing. She tried two contacts and
> reading glasses and found that more of a pain to search for reading
> glasses or wear them around her neck than placing her -175 glasses on
> her head to read or see her food. My aunt's myopic vision gradually
> improved and at almost 70 years old she doesn't need glasses anymore to
> see distance or for reading.
> This poster needs to weigh the pros and cons for himself with his
> lifestyle choices. It seems like glasses are a real hinderance to his
> outdoor activities. But it's not a given that he'll need reading
> glasses. In fact, I think he mentioned that he already removes his
> glasses for reading.

"chances are".

This is a statement that all informed consent's include.

My pre-LASIK #'s were:

Sp As Ax
R -3.50 -1.75 10
L -3.25 -2.50 17

The deal (as I was lead to believe) with presbyopia, is that the
muscles that control the focus of the lens weaken/atrpphy/whatever as
we get older, and a great many people DO in fact need glasses for
close up.

For the sake of this conversation, I hope I don't, but accept it if I
do. I certainly won't go running back to the surgeon whining about
it, as I was warned up front.

I'm currently at:
R +.25 -.25
L - .25 -1.00

Didn't get enuf of the astig on the left. If the # stays the same [at]
3-4 months, I'll likely make the decision whether to ask for an
enhancement.

I left my glasses on all the time, unable to read without them, unless
the page (or item) was inches from my face. My close-up vision is
good, to the point where I need to move small type about 6 inches away
to focus on it (accomodation?)

My decision was a lifestyle one. I was just tired of wearing glasses
& cl's. Not because I hang glide, kayak, swim or anything else.
Though it has improved my shooting, both with camera AND firearm.

Such is MY lifestyle.

heh heh

Rick

#32 03-02-2004, 04:06 AM

In article <itu7409jb6ho7jgeqp4agcopertcrkhlgj[at]4ax.com> ,
SickRick <SR[at]com.com> wrote:

- quote -

> Fact of the matter is; chances are we'll ALL need reading glasses as
> we get older and presbyopia sets in. Something I considered alot -
> why dump glasses, only to have to wear them again soon?

Rick, this is not true. As much as it may pain me to agree with FM, low
myopes do not necessarily need reading glasses as they get older. In
fact, my mother removes her glasses to read. She tried a single contact
for monovision and found it disturbing. She tried two contacts and
reading glasses and found that more of a pain to search for reading
glasses or wear them around her neck than placing her -175 glasses on
her head to read or see her food. My aunt's myopic vision gradually
improved and at almost 70 years old she doesn't need glasses anymore to
see distance or for reading.

This poster needs to weigh the pros and cons for himself with his
lifestyle choices. It seems like glasses are a real hinderance to his
outdoor activities. But it's not a given that he'll need reading
glasses. In fact, I think he mentioned that he already removes his
glasses for reading.

--
"The truth lies somewhere between Ragnar and Flap Melt"
~RT

#31 03-02-2004, 03:24 AM

On 2 Mar 2004 02:07:29 GMT, "Wayne S. Hill" <hillw4[at]asme.org> wrote:

- quote -

> lasik advocate with flap melt wrote:
> > Your myopia range is good for reading up close when you lose
> > all of your accomodation. Your astigmatism isn't that high
> > so you should be able to read fine without glasses. Do you
> > want to give up your near vision, risk your visual acuity
> > and potentially your vision quality to have poorer distance
> > vision that doesn't require (and may not be correctable
> > fully) with glasses or contacts? The tradeoff doesn't make
> > sense once presbyopia sets in.
> Do others agree with this assessment?
> Presbyopia has set in. I'm taking my glasses off and putting them
> on as it is, but have to wear glasses 95% of the time. I'd rather
> reverse that statistic.
> Glasses suck for my outdoor activities. Performing the highland
> games events in the pouring rain wearing glasses is absolutely
> awful (and I have to train/compete whatever the weather). It's a
> bit like taking your glasses, smearing grease on them, and then
> having to concentrate extremely hard on a complex motor skill.
> It's similarly bad with contacts when it's very hot out. Kayaking
> and swimming with glasses or contacts also sucks. I'm willing to
> accept a modest risk to achieve acceptable distance vision without
> glasses, even if I have to wear glasses for night driving or for
> sharpest vision.

Gotta debate this one with f.m.

Fact of the matter is; chances are we'll ALL need reading glasses as
we get older and presbyopia sets in. Something I considered alot -
why dump glasses, only to have to wear them again soon?

Or better yet, look forward to bi/tri-focals or progressives (FYI -
B&L is really pitching thier new progressive contacts), or contacts
AND reading glasses.

Luckily, I do not require reading glasses yet (43 yrs. old).

At any rate, LASIK is really a vanity/lifestyle decision - not like
getting cancer removed.

The "modest risk" all depends on where you fall in your "candidacy"
for LASIK. Get your orb-scans and wavefront exam. See how far you
dialate in a dark room. See how many uncorrectable HOA's that the
wavescan detects, as more than likely these will increase as a result
of the change in corneal shape induced by LASIK.

For me, if ANY of my parameters would have increased the "modest
risk", I would have chosen not to have the procedure done.

Also be aware that glasses usually do not correct the problems
associated with night driving and other LASIK side effects. If it can
be corrected by refraction - it can also be corrected by an
ENHANCEMENT.

I'm dealing with this now, as I still have 1 cyl of astig in my left
eye, and while it's not blinding, it's annoying as hell to have the
right SO SHARP and the left not as sharp. I'll have to decide AGAIN
in a few months whether to get the flap lifted, and try for an
enhancement. This means RE-EVALUATING all the factors for that eye
AGAIN, and the fact that the eye already has had RS, in and of itself,
increases the risk factors.

Rick

#30 03-02-2004, 03:23 AM

Well, RK and AK are pretty ancient in refractive surgery circles.
The excimer laser was approved about a decade ago. You may want to
know what the doctor has done recently.

The clinical trials papers would be at http://www.fda.gov, probably
not on PubMed.

I think $2900 per eye is getting a bit on the high side.

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAeyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

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